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Bilateral Proximal Tibia Stress Fractures through Persistent Physes.

John J Carroll1, Sean P Kelly1, James N Foster1

  • 1Department of Orthopaedic Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA.

Case Reports in Orthopedics
|January 12, 2019
PubMed
Summary
This summary is machine-generated.

This study documents the first proximal tibia stress fractures occurring through persistent physes in a military trainee. These fractures, confirmed by biopsy, highlight a potential risk factor in athletes and soldiers.

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Skeletal biology

Background:

  • Fatigue fractures, or stress fractures, arise from repetitive trauma in areas of high stress.
  • Previous reports identified stress fractures through persistent physes in the olecranon and distal fibula.
  • Proximal tibia stress fractures through persistent physes have not been previously documented.

Observation:

  • A 29-year-old military trainee with varus knee alignment developed bilateral medial tibial plateau stress fractures.
  • Radiographic and laboratory evaluations were performed, followed by operative fixation.
  • Intraoperative specimens revealed abnormal fibrous tissue, with histology confirming hyaline cartilage.

Findings:

  • The patient experienced bilateral proximal tibia stress fractures through persistent physes.
  • Biopsies confirmed the presence of hyaline cartilage at the fracture sites.
  • Persistent physes may increase susceptibility to stress fractures.

Implications:

  • This case suggests persistent physes are a risk factor for proximal tibia stress fractures.
  • Surgical fixation may benefit soldiers and athletes with similar injuries.
  • Further research into the biomechanics of persistent physes and stress fractures is warranted.